A Case of Advanced Gastric Cancer that Developed in a Gastric Conduit after Esophagectomy Reconstructed with a Gastric Tube through the Posterior Mediastinal Route that was Successfully Treated with Preoperative S-1 and Subsequent Partial Gastrectomy

Abstract

A case of a 62-year-old male who had advanced gastric cancer that developed in a gastric conduit 12 years after esophagectomy that was reconstructed with a gastric tube through the posterior mediastinal route is reported. A type 2 advanced gastric cancer (4.5 cm) was present in the upper portion of the gastric conduit. The patient was given 80 mg/m² S-1 daily for 14 days preoperatively. Partial gastrectomy with preservation of the remnant gastric tube was performed after confirmation of tumor remission following S-1 administration. The blood flow in the remnant stomach after tumor resection was confirmed by ICG fluorescence imaging using an SPY system. Histopathological examination showed a grade 3 therapeutic effect by S-1, with granulation and fibrous change in the muscularis propria. The patient is alive 3 years after surgery without recurrence. Preoperative chemotherapy with S-1 appears to be effective for advanced gastric cancer in a gastric conduit after esophagectomy.